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A Field Medic's Guide to First Aid
Author's Note A Field Medic's Guide to First Aid is an educational text written by Bellaria Sunrose. Simple to understand, yet still brimming with knowledge, the piece covers what is essentially the "alphabet" of first aid. From allergies to hemorrhaging, heart attacks, hypothermia and beyond, the reader is provided with a plethora of knowledge in the arts of standard first aid, diagnostics, and decision making. Anaphylaxis (Allergic Reaction) Anaphylaxis, or anaphylactic shock, is a life-threatening allergic reaction that occurs within moments to minutes after exposure to the allergen. It is caused by an overreaction in the immune system, which floods the bloodstream with chemicals that cause the sufferer to experience a sudden drop in blood pressure, followed by a constriction in the airways that causes difficulty breathing. Symptoms *Hypotension (low blood pressure) *Epidermal reactions (itching, inflammation, hives, flushed or pale skin) *Swollen tongue or throat *Constricted airways (can cause wheezing, gasping, trouble breathing) *Weak and rapid pulse *Nausea, vomitus, diarrhea Risk Factors *'Seasonal allergies or asthma:' Those who have either of these conditions are at increased risk of having anaphylaxis. *'Other conditions:' There are other separate instances in which anaphylaxis can occur. Heart disease, mastocytosis, aerobic exercise such as walking or running, eating certain foods before exercise and exercising when the weather is hot, cold or humid have all been known to manifest anaphylaxis. Diagnostics When attempting to diagnose a patient with Anaphylaxis, we must first discover if they have any past experiences with allergic reactions of any level. Common reaction-inducing allergens include: *Particular foods, such as peanuts, almonds, eggs, milk, wheat, etc. *Medications *Rubber, vinyl *Insect stings If we are able to identify a possible allergen, we may proceed to certain testing to confirm the diagnosis. The Tryptase Test is a blood test that measures the presence of tryptase — an enzyme that is often increased in production following anaphylaxis. There are also many other blood and skin tests that you will use to predict the patient's trigger allergen. Emergency Treatment When dealing with an anaphylactic episode, always keep in mind that at any point during treatment, you may be required to perform cardiopulmonary resuscitation, or CPR. While it is our duty to try our hardest to keep such things from coming to pass, it is still important to be mentally and physically prepared for anything. If the patient is breathing, we must begin treatment by administering Epinephrine — or adrenaline — to reduce the intensity of their allergic response. 0.1mg/mL is the dosage level that is widely accepted as treatment for adults. This will usually be administered once every 10-15 minutes. If the patient has gone into cardiac arrest, the dosage level is increased. 1mg/mL is what is initially administered; dosages above this have not been shown to definitively improve survival, or neurological outcomes as compared to standard dosing. Therefore, it is not recommended. If you have access to hospital care supplies such as masks and IVs, provide Oxygen in the form of a mask to help the patient breathe, and support their breathing until they are able to do so unimpeded. Intravenous (IV) antihistamines and cortisone should be established and functioning while you are administering oxygen. Should the patient still have difficulty breathing on their own, you may administer light doses of Swiftthistle to relieve breathing complications. Top Bites and Stings Animal Bites Minor animal bites are common, and most are little to no cause for concern. However, bites from sharp-toothed carnivores such as cats can be deceiving, as the puncture of a fang can leave bacteria deep within the wound. For minor bite wounds: *'Wash the wound' thoroughly with soap and water. *Apply an antibiotic cream and cover the bite with a clean bandage. Snake Bites: Most kinds of snakes are fairly harmless to people, but there are some who still pose a threat with the venom they can produce. Snake bites are most commonly sustained on the extremities. Nonvenomous snake bites are usually accompanied by pain, irritation of the skin, and scratches at the site. Symptoms *Severe burning pain at the site within 15 to 30 minutes of being bitten *Moderate to severe swelling and bruising in the wound, and often all the way up the arm or leg *Nausea and general weakness *Odd or unfamiliar taste in the mouth *Neurological issues such as tingling and difficulty speaking Treatment If the bite is from a nonvenomous snake, treatment of the bite wound is of standard animal bite procedure. However, if the bite is from a venomous snake: *Remain calm and move beyond the snake's striking distance. *Remove jewelry and tight clothing before swelling begins. *Position the patient so that the bite is at or below the level of their heart. *Clean the wound without the usage of water. Cover it with a clean, dry dressing. *Administer 20 to 50 ml of antivenom from your antivenom kit, diluted in 3 volumes of 0.9% saline. Give it by intravenous (IV) infusion diluted in a drip, or by slow bolus injection. The dose often depends on the type of antivenom, and the type of snake identified. Caution *'Do not' use a tourniquet or apply ice. *'Do not' cut the wound or attempt to remove the venom without knowing a proper venom-removing procedure. *'Do not' let the patient drink caffeine or alcohol, which could speed their body's absorption of venom. Humanoid Bites Humanoid bites can be as dangerous as, or even moreso, than animal bites because of the types of bacteria and viruses contained in most humanoid mouths. Bites that break the skin can become infected. Cutting one's skin on another person's teeth, or one's own teeth, is also considered a bite. To properly tend to a humanoid bite: *'Stop the bleeding' by applying pressure with a clean, dry cloth. *'Wash the wound' thoroughly with soap and water. *'Apply a clean dressing' and change it daily. Insect Bites and Stings Most reactions to insect bites and stings are mild, causing little more than redness, itching, stinging or minor swelling. Rarely, insect bites and stings, such as from a bee, a wasp, a hornet, a fire ant or a scorpion, can result in severe reactions. In the case of mild reactions: *'Remove the stinger' if needed. *'Wash the area' with soap and water. *'Apply a cool compress'. Use a cloth dampened with cold water or filled with ice. This helps reduce pain and swelling. If the injury is on an arm or leg, elevate it. *'Apply a cream, gel or lotion to the injured area'. Use products containing ingredients such as hydrocortisone or lidocaine to help control pain. Use creams such as calamine lotion or those containing colloidal oatmeal or baking soda to help soothe itchy skin. Top Black Eyes A black eye is caused by subdermal (underneath the skin) bleeding. While most injuries that cause black eyes are fairly minor, there are some instances where it may be an indication of a more serious issue. Internal injuries to the eye, fractured socket bones, allergic reactions, and other more subtle problems may produce a black eye. To efficiently treat a regular black eye: *Begin by applying a cold compress as quickly as possible to reduce swelling. *With the cold compress, gently place slight pressure on the areas around the eye. *'Do not put pressure on the eye itself.' Symptoms of Trauma Skulls fractures and other forms of head trauma can also cause black eyes. Other symptoms of more serious damage include: *Raccoon eyes (bruising around both eyes) *Double vision *Severe head or eye pain *Blurry vision *Epistaxis (nosebleed) *Bleeding in the eye In the case of confirmation of head trauma, follow the standard head trauma protocol. Top Bruises A bruise is formed when a blow to the area is powerful enough to break blood vessels just beneath the skin's surface. The blood then leaks into the tissue underneath your skin where it becomes trapped, creating a darkened hue that fades over time. This is why fresh bruises are sort of black and blue in color, whereas bruises that have almost fully healed are a brownish, sometimes yellowed shade. Because bruises are usually of little concern, it is encouraged that one simply leave it to recover naturally. But, there are a few ways to help accelerate bruise healing: *'Elevate' the area. *'Apply cold' to the bruise for 10 minutes at a time. Repeat several times a day. Minor, non-euphoric painkillers may also be considered, such as Moonflower or Bruiseweed. Top Blisters A blister is a bubble of serosanguineous fluid (blood and the liquid part of blood, known as 'serum') on the skin. They are normally caused by friction or burning. If a blister is not too painful, it is strongly suggested that it be kept intact, as the unbroken skin over a blister may provide a natural barrier to bacteria, thus reducing the risks of infection. Instead keep it covered with an adhesive bandage or other proper dressing that is changed daily. Draining a Blister Blister-related pain can be alleviated by draining the fluid while leaving the overlying skin intact: *'Wash your hands and the blister' with soap and warm water. *'Swab the blister' with iodine, or another antiseptic. *'Puncture the blister' with a sterilized needle. *'Apply a medicinal ointment' and properly dress the wound. Burns Before one can begin adequate treatment of a burn, you must first discern the severity of the injury itself. There are varying levels of damage that can be caused. Severity 1st Degree A first-degree burn is the least serious type, involving only the outer layer of skin. These may cause: *Redness *Swelling *Mild to moderate pain 2nd Degree A second-degree burn is more damaging than before. It may cause: *Red, white or splotchy/mottled skin *Swelling *Pain *Blisters 3rd Degree The most serious burns involve all layers of the skin and underlying fat. Muscle and even bone may be affected. *Difficulty breathing *Carbon monoxide poisoning or other toxic effects from inhalation *Burned areas may be charred black or white Treating Minor Burns *'Cool the burn' to help soothe the pain. Hold the burned area under cool running water for 10 to 15 minutes, or until the pain eases. Apply a clean towel dampened with cool tap water as an alternative if the rushing of water causes more pain. *'Remove tight items' from the burn area, such as jewelry or string before swelling occurs. *'Apply Goldthorn gel' to alleviate pain. *'Remember: Leave minor blisters intact.' If blisters break, gently clean the area with mild soap and water, apply an antibiotic ointment, and dress the wound. Top Cardiopulmonary Resuscitation (CPR) Cardiopulmonary resuscitation, or CPR, is a lifesaving technique that is useful in many emergencies where the patient's heart has stopped beating. Remember to perform CPR only if the patient's heart has completely ceased in function. In this section, we will discuss varying levels of the procedure, as well as the conditions that must be met before one performs treatment. CPR can keep oxygenated blood flowing to the brain and other vital organs until more definitive medical treatment can restore a normal heart rhythm. When the heart stops, the lack of oxygenated blood can cause brain damage in only a few minutes. A person may die within eight to 10 minutes. The advice below applies to adults, children and infants requiring CPR, but not newborns. Levels of Experience *'Untrained:' If you are a novice medic, or otherwise entry-level experience in this procedure, then provide hands-only CPR. Perform 100-120 uninterrupted chest compressions until: **Someone of higher experience arrives to replace you. **You become too exhausted to continue treatment. **The patient's pulse returns. *'Trained:' If you're well-trained and confident in your ability, start CPR with 30 chest compressions before checking the airway and giving 2 large rescue breaths (mouth-to-mouth). Continue this until: **Someone of equal or higher experience arrives to replace you. **You become too exhausted to continue treatment. **The patient's pulse returns. The Five Checkpoints Before beginning CPR, check: *Is the scene safe? — If you and the patient are in a location that is unsafe for the both of you, including areas such as busy streets, under active fire, or areas behind enemy lines, do not step in to perform CPR. Remember that if the medic goes down, everyone goes down. *Is the person conscious or unconscious? — CPR should only be performed if the patient is totally unresponsive, including breathing and pulse. *If the person doesn't respond and two or more people are present, get someone to make contact with other emergency treatment personnel while you work. **'Remember to point out someone in particular.' There is something known as the bystander effect, in which individuals are less likely to offer help to a victim when other people are present. Directly addressing a specific person helps to eliminate this factor. *If an AED (automated external defibrillator) is readily available, use the device to deliver one electrical shock before beginning CPR. Step By Step *'1.' — Put the person on his or her back on a firm surface. *'2.' — Kneel next to the person's neck and shoulders. *'3.' — Place the heel of one hand over the center of the person's chest, between the nipples. Place your other hand on top of the first hand. Keep your elbows straight and position your shoulders directly above your hands. *'4.' — Use your upper body weight (not just your arms) as you push straight down on the chest at least 2 inches, but no greater than 2.4 inches. Perform 30 chest compressions. *'5.' — After you've performed 30 chest compressions, open the person's airway by tilting the head and lifting the chin. Put your palm on the person's forehead and gently tilt the head back. Then with the other hand, gently lift the chin forward to open the airway. *'6.' — Check for normal breathing, taking no more than five or 10 seconds. Look for chest motion, listen for normal breath sounds, and feel for the person's breath on your cheek and ear. Gasping is not considered to be normal breathing. *'7.' — Once the airway is open, pinch the nostrils shut for mouth-to-mouth breathing and cover the person's mouth with yours, making a seal. *'8.' — Give the first rescue breath and watch to see if the chest rises. If it does, give the second breath. If the chest doesn't rise, repeat the head-tilt, chin-lift maneuver and then give the second breath. Top Choking Choking occurs when a foreign object lodges in the throat or windpipe, blocking the flow of air. In the case of choking adults, a piece of food is often the source of choking, whereas attempting to swallow small objects is often the culprit in young children. Because choking prevents oxygen from flowing to the brain, it is important that we perform first aid to remove the object as soon as possible. Signs of Choking The universal sign for choking is both hands clutched around the throat. However, if a person does not give this signal, there are other ways to determine if they are choking: *Inability to talk *Difficulty breathing or noisy breathing *Squeaky sounds when trying to breathe *Cough, which may either be weak or forceful *Skin, lips and nails turning blue or dusky *Skin that is flushed, then turns pale or bluish in color *Loss of consciousness Abdominal Thrusts If the victim is able to cough, encourage them to continue coughing in order to help dislodge the object. If they are choking and cannot cry, talk, or laugh, beginning performing the Heimlich Maneuver, also known as abdominal thrusts: *'Take position behind the victim.' Make sure your stance is balanced, such as placing one foot in front of the other for reinforcement. Wrap your arms around the victim's waist. If the victim is a child, kneel behind them. *'Make a fist with one hand'. Position it slightly above the victim's navel, or bellybutton. *'Reinforce the fist by grasping it with your other hand.' Press hard into the abdomen with a quick, upward thrust — as if trying to lift the person up. *'Perform between 6-10 thrusts at a time', or until the blockage is dislodged. Obesity and Pregnancy To clear the airway of a pregnant woman or obese person: *'Position your hands a little bit higher' than with a normal Heimlich maneuver, at the base of the breastbone, just above the joining of the lowest ribs. For pregnant women, this will be immediately above the "baby bump". *'Proceed as with the standard maneuver', pressing hard into the chest, with a quick thrust. Repeat until the food or other blockage is dislodged. Unconscious Victims To clear the airway of an unconscious person: *'Lower the person on his or her back' onto the floor, arms to the side. *'Open the mouth.' If a blockage is visible at the back of the throat or high in the throat, reach a your index and middle finger into the mouth and scoop out the cause of the blockage. Don't try a finger sweep if you can't see the object. Be careful not to push the food or object deeper into the airway, which can happen easily in young children. *'Begin CPR' if the object remains lodged and the person doesn't respond after you take the above measures, and cannot sense a pulse. The chest compressions used in CPR may dislodge the object. **Remember to recheck the mouth periodically. Infants If a child under the age of 1 is choking, the process is different. *'Assume a seated position' and hold the infant facedown on your forearm, which is resting on your thigh. Support the infant's head and neck with the crook of your elbow, and place the head lower than the trunk, or torso. *'Thump the infant gently but firmly' five times on the middle of the back using the heel of your hand. The combination of gravity and the back blows should release the blocking object. Keep your fingers pointed up to avoid hitting the infant in the back of the head, and remember not to hit them full-force. *'Turn the infant face up' on your forearm, resting on your thigh with the head lower than the trunk if the infant still isn't breathing. Using two fingers placed at the center of the infant's breastbone, give five quick chest compressions. Press down about 1 1/2 inches, and let the chest rise again in between each compression. Top Cuts and Scrapes Injuries such as scrapes and light cuts do not normally need emergency medical attention. However, if the wound is deep or exposing fat or muscle, proper wound cleansing and closure (such as stitches) will be required as quickly as possible. To properly handle minor cuts and scrapes: *'Wash your hands:' Always wash your hands before handling any wound to help avoid infection. *'Stop the bleeding:' Minor cuts and scrapes usually stop bleeding on their own. If needed, apply gentle pressure with a clean bandage or cloth and elevate the wound until bleeding stops. *'Clean the wound:' Rinse the wound with cool to lukewarm water, so as not to irritate the injury. If you have access to a faucet of water, holding the wound underneath the running tap will reduce the risk of infection. Lightly wash around the wound with soap, but be careful not to get it into the injury, as this can be irritating. Avoid using iodine or hydrogen peroxide on minor abrasions, as these can also be irritating to the wound. Make sure that any debris has been removed gently with a swab or cleaned tweezers. *'Apply an antibiotic:' Apply a thin layer of an antibiotic ointment or petroleum jelly to keep the surface moist and help prevent scarring. Certain ingredients in some ointments can cause a mild rash in some people. If a rash appears, stop using the ointment. *'Cover it:' A bandage, rolled gauze, or other covering help keeps the wound clean. If the injury is just a minor scrape or scratch, it is preferably left uncovered to hone the patient's immune system. *'Always make sure to change the dressing daily.' *'Tetanus shots:'It is advised that patients receive tetanus shot if they haven't had one in the past five years, and the wound is deep or dirty. Top Dislocation (Bone) Top Epistaxis (Nosebleed) Top Fainting Top Fever Top Fractures (Bone) Top Frostbite Top Head Pain Head Trauma Top Heat Exposure Heatstroke Top Heart Attack Top Hemorrhaging (Extreme Bleeding) Top Hypothermia Top Poisoning Food Poisoning Top Puncture Wounds Top Seizures Top Spinal Injury Top Stroke Top Author's Note This page is a work in progress, and is far from finished. Some of this content is indeed accurately comparable to real-life situations, as the concept of treating most wounds with first aid supplies is often the same. However, things have also been tweaked here and there because, after all, the genre of Warcraft is indeed fantasy. Much of this comparable information is provided by several excellent sources of real-life information, including the Mayo Clinic, and a hefty load of my own medical textbooks from school. All information contained on this page is written purely for RP resource purposes, and is not required to be acknowledged by anyone. However, if the reader decides they enjoy this content and wishes to do so, they are absolutely more than welcome to claim its existence and information in-character through RP. Please let me know if you do, because not only do I like to see when people enjoy my writing and content, but to open up new avenues for Roleplay in the future! ♥ Top Category:Books Category:Medicine Category:First Aid